Journal of Youth and Adolescence

, Volume 33, Issue 1, pp 71–80 | Cite as

Prevalence and Predictors of Sexual Risks Among Homeless Youth

  • Linda L. Halcón
  • Alan R. Lifson


This study examined prevalence of sexual risks among homeless adolescents and described factors associated with those risks. Community-based outreach methods were used successfully to access this difficult-to-reach population. The sample included 203 homeless youth aged 15–22 recruited from community sites. Questionnaire items addressed demographics, sexual behaviors, alcohol/drug use, STI history and testing, and pregnancy history. In cross-sectional analysis, 58.7% of males and 75.6% of females reported recent sexual intercourse. Of those, one third of males and half of the females used no barrier method with at least one partner. Both gender (female) and race/ethnicity (non-Black) were associated with having intercourse without a barrier contraceptive method. Over one fifth reported a history of “survival sex” or receiving money, drugs, clothing, shelter, or food for sex. These results show disturbingly high rates of a number of sexual risks, reinforcing the need for targeted interventions with this highly vulnerable population.

homeless youth adolescents sexual behavior 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Allen, D. M., Lehman, J. S., Green, T. A., Lou, L. M., Onorato, I. M., Forrester, W., and Branch, F. S. (1994). HIV infection among homeless adults and runaway youth, United States, 1989–1992. AIDS 8: 1593–1598.Google Scholar
  2. Bailey, S. L., Camlin, C. S., and Ennett, S. T. (1998). Substance use and risky sexual behavior among homeless and runaway youth. J. Adolesc. Health 23(6): 378–388.Google Scholar
  3. Blattner, W. A., O'Brien, T. R., and Mueller, N.E. (1997). Retroviruses—Human immunodeficiency virus. In Evans, A. S., and Kaslow, R. A. (eds.), Viral Infections of Humans: Epidemiology and Control (4th edn.) Plenum Medical Book Company, New York, pp. 713–783.Google Scholar
  4. Chin, J. (ed.) (2000). Control of Communicable Diseases Manual (17th edn.)., Washington, D.C.: American Public Health Association.Google Scholar
  5. Clatis, M. C., and Davis, W. R. (1999). A demographic and behavioral profile of homeless youth in New York City: Implications for AIDS outreach and prevention. Med. Anthropol. Q. 13(3): 365–374.Google Scholar
  6. Clatts, M. C., Davis, W. R., Sotheran, J. L., and Atillasoy, A. (1998). Correlates and distribution of HIV risk behaviors among homeless youths in New York City: Implications for prevention and policy. Child Welfare 77(2): 195–207.Google Scholar
  7. Clements, K., Gleghorn, A., Garcia, D., Katz, M., and Marx, R. (1997). A risk profile of street youth in northern California: Implications for gender-specific human immunodeficiency virus prevention. J. Adolesc. Health 20(5): 343–353.Google Scholar
  8. DiClemente, R. J., Hansen, W. B., and Ponton, L. E. (1996). Adolescents at risk: A generation in jeopardy. In DiClemente, R. J., Hansen, W. B., and Ponton, L. E. (eds.), Handbook of Adolescent Health Risk Behavior. Plenum, New York, pp. 1–4.Google Scholar
  9. Division of STD Prevention (1996). Sexually Transmitted Disease Surveillance 1995. Centers for Disease Control and Prevention, DHHS-PHS, Atlanta, GA.Google Scholar
  10. Ebrahim, S. H., Peterman, T. A., Zaidi, A. A., and Kamb, M. L. (1997). Mortality related to sexually transmitted diseases in U.S. women, 1973 through 1992. Am. J. Public Health 87(6): 938–944.Google Scholar
  11. Farrow, J. A., Deisher, R.W., Brown, R., Dulig, J.W., and Kipke, M. D. (1992). Health and health needs of homeless and runaway youth: A position paper of the Society for Adolescent Medicine. J. Adolesc. Health 13(8): 717–726.Google Scholar
  12. Finkelhor, D., Hotaling, G., and Sedlak, A. (1990). Missing, Abducted, Runaway, and Thrownaway Children in America. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention, Washington, DC.Google Scholar
  13. Fortenberry, J. D. (1995). Adolescent substance use and sexually transmitted disease risk: A review. J. Adolesc. Health 16: 304–308.Google Scholar
  14. Greenblatt, M., and Robertson, M. J. (1993). Life-styles, adaptive strategies, and sexual behaviors of homeless adolescents. Hosp. Community Psychiatry 44(12): 1177–1180.Google Scholar
  15. Greene, J. M., Ennett, S. T., and Ringwalt, C. L. (1997). Substance use among runaway and homeless youth in three national samples. Am. J. Public Health 87(2): 229–235.Google Scholar
  16. Greene, J. M., Ennett, S. T., and Ringwalt, C. L. (1999). Prevalence and correlates of survival sex among runaway and homeless youth. Am. J. Public Health 89(9): 1406–1409.Google Scholar
  17. Greene, J. M., and Ringwalt, C. L. (1998). Pregnancy among three national samples of runaway and homeless youth. J. Adolesc. Health 23(6): 370–377.Google Scholar
  18. Huba, G. J., Melchior, L. A., Panter, A. T., Trevithick, L., Woods, E. R., Wrigt, E., Feudo, R., Tierney, S., Schneir, A., Tenner, A., Remafedi, G., Greenberg, B., Sturdevant, M., Goodman, E., Hodgins, A., Wallace, M., Brady, R., and Singer, B. (2000). Risk factors and characteristics of youth living with, or at high risk for, HIV. AIDS Educ. Prev. 12(6): 557–575.Google Scholar
  19. Huizinga, D., Loeber, R., and Thornberry, T. P. (1993). Longitudinal study of delinquency, drug use, sexual activity, and pregnancy among children and youth in three cities. Public Health Rep. 108(Suppl. 1): 90–96.Google Scholar
  20. Igra, V., and Irwin, C. E. (1996). Theories of adolescent risk-taking behavior. In DiClemente, R. J., Hansen, W. B., and Ponton, L. E. (eds.), Handbook of Adolescent Risk Behavior. Plenum, New York, pp. 35–51.Google Scholar
  21. Kipke, M. D., O'Connor, S., Palmer, R., and MacKenzie, R. G. (1995). Street youth in Los Angeles: Profile of a group at high risk for human immunodeficiency virus infection. Arch. Pediatr. Adolesc. Med. 149: 513–519.Google Scholar
  22. Kral, A. H., Molnar, B. E., Booth, R. E., and Watters, J. K. (1997). Prevalence of sexual risk behaviour and substance use among runaway and homeless adolescents in San Francisco, Denver and New York City. Int. J. STD AIDS 8: 109–117.Google Scholar
  23. Leigh, B. C., Morrison, D. M., Trocki, K., and Temple, M. T. (1994). Sexual behavior of American adolescents: Results from a U.S. national survey. J. Adolesc. Health 15: 117–125.Google Scholar
  24. Lifson, A. R., and Halcon, L. L. (2001). Substance abuse and high-risk needle-related behaviors among homeless youth in Minneapolis: Implications for prevention. J. Urban health 78(4): 690–698.Google Scholar
  25. Link, B. G., Susser, E., Stueve, A., Phelan, J., Moore, R. E., and Struening, E. (1994). Lifetime and five-year prevalence of homelessness in the United States. Am. J. Public Health 84(12): 1907–1912.Google Scholar
  26. Macdonald, N. E., Fisher, W. A., Wells, G. A., Doherty, J. A., and Bowie, W. R. (1994). Canadian street youth: Correlates of sexual risk-taking activity. Pediatr. Infect. Dis. J. 13: 690–697.Google Scholar
  27. MacKellar, D. A., Valleroy, L. A., Hoffmann, J. P., Glebatis, D., LaLota, M., McFarland, W., Westerholm, J., and Janssen, R. S. (2000). Gender differences in sexual behaviors and factors associated with nonuse of condoms among homeless and runaway youths. AIDS Educ. Preve. 12(6): 477–491.Google Scholar
  28. Martinez, T. E., Gleghorn, A., Marx, R., Clements, K., Boman, M., and Katz, M. H. (1998). Psychosocial histories, social environment, and HIV risk behaviors of injection and noninjection drug using homeless youth. J. Psychoactive Drugs 30(1): 1–10.Google Scholar
  29. Minnesota Department of Human Services, Performance and Quality Improvement Division (1996). Minnesota Student Survey 1989–1992–1995: Perspectives on Youth. Department of Children, Families and Learning, St. Paul, MN.Google Scholar
  30. Noell, J., Rohde, P., Ochs, L., Yovanoff, P., Alter, M. J., Schmid, S., Blullard, J., and Black, C. (2001). Incidence and prevalence of chlamydia, herpes, and viral hepatitis in a homeless adolescent population. Sex. Transm. Dis. 28(1): 4–10.Google Scholar
  31. Pennbridge, J. N., Freese, T. E., and MacKenzie, R. G. (1992, Fall). High-risk behaviors among male street youth in Hollywood, California. AIDS Educ. Prev. (Suppl.) 24–33.Google Scholar
  32. Pharris, M. D. (1998). Consent and Confidentiality: Providing Medical and Mental Health Services to Minors in Minnesota. Hennepin County Medical Center, Sexual Assault Resource Services, Minneapolis, MN.Google Scholar
  33. Rew, L., Fouladi, R. T., and Yockey, R. D. (2002). Sexual health practices of homeless youth. J. Nurs. Scholarsh. 34(2): 139–145.Google Scholar
  34. Rew, L., Taylor-Seehafer, M., and Fitzgerald, M. L. (2001). Sexual abuse, alcohol and other drug use, and suicidal behaviors in homeless adolescents. Issues in Compr. Pediatr. Nurs. 24: 225–240.Google Scholar
  35. Rew, L., Taylor-Seehafer, M., and Thomas, N. (2000). Without parental consent: Conducting research with homeless adolescents. JSPN 5(3): 131–138.Google Scholar
  36. Ringwalt, C. L., Greene, J. M., Robertsoln, M., and McPheeters, M. (1998). The prevalence of homelessness among adolescents in the United States. Am. J. Public Health 88(9): 1325–1329.Google Scholar
  37. Rotheram-Borus, M. J., and Koopman, C. (1991). Sexual risk behaviors, AIDS knowledge, and beliefs about AIDS among runaways. Am. J. Public Health 81(2): 208–210.Google Scholar
  38. Sherman, D. J. (1992). The neglected health care needs of street youth. Public Health Rep. 107(4): 433–440.Google Scholar
  39. Shew, M. L., Remafedi, G. J., Bearinger, L. H., Faulkner, P. L., Taylor, B. A., Potthoff, S. J., and Resnick, M. D. (1997). The validity of self-reported condom use among adolescents. Sex. Transm. Dis. 24(9): 503–510.Google Scholar
  40. Stricof, R. L., Kennedy, J. T., Nattell, T. C., Weisfuse, I. B., and Novick, L. F. (1991). HIV seroprevalence in a facility for runaway and homeless adolescents. Am. J. Public Health 81(Suppl.): 50–53.Google Scholar
  41. Taylor, V. E. (1993). Analysis of the differences and similarities between homeless people seen at on-site health clinics in soup kitchens and shelters. In Hunter, J. K. (ed.), Nursing and Health Care for the Homeless State University of New York Press, New York, pp. 65–70.Google Scholar
  42. Wagner, L. S., Carlin, L., Cauce, A. M., and Tenner, A. (2001). A snapshot of homeless youth in Seattle: Their characteristics, behaviors and beliefs about HIV protective strategies. J. Community Health 26(3): 219–232.Google Scholar
  43. Wenzel, S. L., Andersen, R. M., Gifford, D. S., and Gelberg, L. (1999). Homeless women's gynecological symptoms and use of medical care. J. Health Care Poor Underserved 12(3): 323–341.Google Scholar
  44. Wilder Research Center (1998). Minnesota Statewide Survey of Persons Without Permanent Shelter, Vol. 2: Unaccompanied youth. St. Paul, MN: Amherst H. Wilder Foundation.Google Scholar
  45. World Health Organization, Task Force on the Prevention and Management of Infertility (1995). Tubal infertility: Serologic relationship to past chlamydial and gonococcal infections. Sex. Transm. Dis. 22(2): 71–77.Google Scholar
  46. Yates, G. R., MacKenzie, J., Pennbridge, and Cohen, E. (1988). A risk profile comparison of runaway and non-runaway youth. Am. J. Public Health 78: 820–821.Google Scholar

Copyright information

© Plenum Publishing Corporation 2004

Authors and Affiliations

  • Linda L. Halcón
    • 1
  • Alan R. Lifson
    • 2
  1. 1.University of MinnesotaMinneapolis
  2. 2.Division of Infectious Diseases, School of MedicineUniversity of MinnesotaUSA

Personalised recommendations